Botulinum toxin in masticatory muscles: short- and long-term effects on muscle, bone, and craniofacial function in adult rabbits.
Botulinum toxin in masticatory muscles: short- and long-term effects on muscle, bone, and craniofacial function in adult rabbits.
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DOI：
10.1016/j.bone.2011.11.015
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发表时间：
2012-03
期刊：
影响因子：
4.1
通讯作者：
Herring, Susan W.
中科院分区：
文献类型：
--
作者：
Rafferty, Katherine L.;Liu, Zi Jun;Ye, Wenmin;Navarrete, Alfonso L.;Thao Tuong Nguyen;Salamati, Atriya;Herring, Susan W.
关键词：
使用肉毒杆菌毒素（BTX）的咀嚼肌麻痹是一种常见的治疗方法，用于咬肌的美容减少以及涉及肌肉痉挛和疼痛的情况。这种治疗对咀嚼的影响尚未得到评估，并且声称这种治疗减轻了颌关节和下颌骨的负荷尚未得到验证。如果BTX治疗确实降低了下颌骨负荷，则骨质减少可能作为不良结果而发生。随机选择一只家兔咬肌，给予BTX或生理盐水单次给药，并随访4周或12周。每周评估咀嚼肌活动，并定期测量每个咬肌刺激引起的切牙咬合力。在实验终点，将应变计安装在下颌骨髁突颈部和下颌骨磨牙区，用于在咀嚼和肌肉刺激期间记录体内骨应变。处死后，称重肌肉，用微型CT扫描下颌骨节段。BTX的一个咬肌麻痹并没有改变咀嚼侧或率，部分原因是由内侧翼肌补偿。咬肌诱导咬合力显著下降。骨应变数据的分析表明，在4周时，BTX注射侧的下颌髁突负荷不足，磨牙区的两侧也是如此。骨的数量和质量严重下降，特别是在这些欠载位置，特别是注射侧髁头。在12周时，大多数功能参数接近其注射前的水平，但注射咬肌仍然表现出萎缩，髁状突头部的骨面积百分比仍然很低。总之，虽然咀嚼的性能只有最低限度的损害由BTX的咬肌麻痹，由此产生的欠载足以引起显着的和持续的骨丢失，特别是在颞下颌关节。
Paralysis of the masticatory muscles using botulinum toxin (BTX) is a common treatment for cosmetic reduction of the masseters as well as for conditions involving muscle spasm and pain. The effects of this treatment on mastication have not been evaluated, and claims that the treatment unloads the jaw joint and mandible have not been validated. If BTX treatment does decrease mandibular loading, osteopenia might ensue as an adverse result. Rabbits received a single dose of BTX or saline into one randomly chosen masseter muscle and were followed for 4 or 12 weeks. Masticatory muscle activity was assessed weekly, and incisor bite force elicited by stimulation of each masseter was measured periodically. At the endpoint, strain gages were installed on the neck of the mandibular condyle and on the molar area of the mandible for in vivo bone strain recording during mastication and muscle stimulation. After termination, muscles were weighed and mandibular segments were scanned with micro CT. BTX paralysis of one masseter did not alter chewing side or rate, in part because of compensation by the medial pterygoid muscle. Masseter-induced bite force was dramatically decreased. Analysis of bone strain data suggested that at 4 weeks, the mandibular condyle of the BTX-injected side was underloaded, as were both sides of the molar area. Bone quantity and quality were severely decreased specifically at these underloaded locations, especially the injection-side condylar head. At 12 weeks, most functional parameters were near their pre-injection levels, but the injected masseter still exhibited atrophy and percent bone area was still low in the condylar head. In conclusion, although the performance of mastication was only minimally harmed by BTX paralysis of the masseter, the resulting underloading was sufficient to cause notable and persistent bone loss, particularly at the temporomandibular joint.
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